Efetividade dos antivirais de ação direta de segunda geração em pacientes infectados com o vírus da hepatite c e fatores associados a uma resposta virológica não sustentada

Abstract

Hepatitis c is currently a relevant public health issue in brazil and worldwide. It is Estimated that around 58 million people are infected with the hepatitis c virus (hcv) And that around 290,000 die every year due to complications from this disease. In brazil, The treatment of hepatitis c went through several stages until reaching current schemes. Direct action antivirals (daa) were introduced and incorporated into the unified health System (sus) as of 2015 to ensure better results. The objective of this study was to Determine the clinical characteristics of patients who received second-generation daa And the effectiveness of the treatment, based on the medical records of the viral hepatitis Outpatient clinic in the city of uruguaiana (rs) from december 2017 to august 2020. Of the 199 patients analyzed, 55.8% were male. The mean age found was 55.08 ± 9.91 Years and 68.2% declared themselves white. Most of them had initial degree of fibrosis F0-f1 (47.8%). Genotype 1 and its subtypes were the most frequent (63.3%) followed by Genotype 3 (32.1%). The influence of the use of these antivirals on laboratory parameters Showed a significant decrease in the levels of aspartate aminotransferase (ast), alanine Aminotransferase (alt), alkaline phosphatase, gamma-glutamyltranspeptidase (gamma Gt), total bilirubin and fractions and glycated hemoglobin. The results of total Cholesterol, hdl and ldl showed a significant increase after treatment. In the Multivariate analysis, as significant results, genotypes 1a and 3 were 7.3 and 6.0 times, Respectively, more likely to result in detectable sustained virological response (svr) When compared to genotype 1b, as well as the cardiovascular comorbidity variable as Well. indicated a higher risk of absence of svr. The results of this study showed that Second-generation daa had a high rate of effectiveness, in agreement with previous Studies carried out in other countries and other regions of brazil, and may contribute to The country meeting the goal of the plan for the elimination of hepatitis c proposed by The who.